B2: Reducing overtesting and increasing value

Thursday 19th September 2019

Part A: Overtesting and its safety risk for patients in Japan

Although overtesting is a serious issue in the world, research in this area has been published by mainly US and European countries. Japan has the highest number of imaging machines in the world and the national medical expense in Japan is gradually increasing. In this session, we present our recent data about overtesting and its safety risk for patients in Japan. We also show the difference and similarities about features of overtesting between Japan and other countries.

After this session, participants will be able to:

1. Understand the current status of overtesting in Japan

2. Understand mechanisms leading to overtesting and its safety risk among patients in Japan

3.Understand possible solutions for overtesting in Asian countries

Masaru Kurihara, Department of Internal Medicine, Urasoe General Hospital, Okinawa; Japan

Part B: Deprescribing safely in acute and aged medicine

Hospital-based deprescribing represents an opportunity to reduce potential drug interactions, medication side effects and events like falls and hospital readmissions. This session will explore the practicalities and pitfalls of deprescribing which should enable simplified integration of appropriate and effective deprescribing into standard daily work.

After this session, participants will be able to:

  1. Understand deprescribing and its challenges

  2. Identify methods for simple yet effective deprescribing

  3. Develop deprescribing protocols

Kylie Hall, Nurse Unit Manager, Eastern Health; Australia

Vikas Wadhwa, Clinical Director of Integrated Services, Eastern Health; Australiant involvement.

Part C: Improving healthcare outcomes in the era of pay-for-value: Empirical examples in Taiwan

This session will cover the method that Professor Wang’s team have developed for estimating cost-effectiveness in health and medicine. Following three examples will be shared on how values of the patients and society could be improved for patients with prolonged mechanical ventilation(PMV), hemodialysis and peritoneal dialysis, and oral cancer screening. After this session, the audience will be able to appreciate cost-effectiveness in following 3 clinical practices: For patients at terminal stage, PMV had better be discontinued early; for patients with end-stage renal disease, peritoneal dialysis could be recommended first if there is no contraindication; screening of oral cancer would be more cost-effective if patients with abnormal oral pathology or early lesions could be followed every 3-6 months.

Jung-Der Wang, Chair Professor, Institute of Public Health, National Cheng Kung University College of Medicine; Taiwan